Franklinton pediatrician struggles to help some of the city's poorest patients and still pay his bills -

Last weekend, the gas was turned off at Dr. Edward Cutler's Franklinton office.

It wasn't the first time.

And he just avoided an electricity shutoff by paying an overdue $400 bill.

On Tuesday, Columbia Gas reconnected service after Cutler paid his bill.

Now, he has to replace a water heater.

Such is the life of a pediatrician who serves scores of the poorest patients in a part of town
where few doctors practice."

I make nothing. I haven't paid myself a salary," said Cutler, who now uses credit cards to pay
bills.

So why does he stay?

"I don't know," Cutler said. But he added: "I'd like to practice until I die."

The federal government has designated Franklinton a health-professional-shortage area. It's
difficult to earn a lot of money in an area with so many poor people.

Doctors are nearby. Nationwide Children's Hospital runs a Close To Home clinic on the Hilltop,
which is west of Franklinton; the city of Columbus recently opened a Hilltop neighborhood health
clinic on W. Broad Street; and Mount Carmel West hospital is in Franklinton. Cutler, however, says,
"I'm the only pediatrician in the poorest part of town."

Many of his patients are on Medicaid. He said he never knows when CareSource, a third-party,
private Medicaid provider, will process his claims, making it difficult for him to manage his cash
flow.

He said at least 600 patients are covered through CareSource, based in Dayton.

"It's a nightmare keeping track of what gets paid and not paid," said Cutler, who added that he
can't afford an office manager.

Dr. Terry Torbeck, CareSource's medical director, said the company treats Cutler like every
other doctor. CareSource works with 23,000 health-care providers in Ohio.

"We understand he has a small practice (that serves) difficult areas of town. We think he takes
good care of his patients," Torbeck said. "It's just that his style is probably not meant for
managed care.

"He wants to practice medicine without the restrictions that come from participating in a
managed-care plan."

Cutler acknowledges that he is not a great businessman.

"If I were, I'd make making money a priority," he said. " I'm a doctor. The business part of
medicine is taking precedence over the profession of medicine."

Cutler is dedicated to his patients, said Dr. Tom Peponis Jr., who has a family practice on the
Hilltop. He called Cutler "brilliant" and said he hates to see bureaucratic pitfalls wearing him
down.

"He chooses to serve that community where nobody else will," Peponis said.

Cutler's office was without natural gas for eight months last year. It was disconnected in March
2009 because he owed $400 in bills. He had no hot water.

Last year, his financial problems became so bad, he reached out to fellow doctors on a physician
listserv, asking that 10 physicians each lend him $1,000.

"My telephone and electric service are in jeopardy of being turned off, and I don't know how I
will pay my American Express bill, which must be paid within three days; and I depend upon American
Express for cash flow since I have no line of credit," he wrote.

He estimated that he received about $3,000.

"They helped me out in a terrible crisis," Cutler said.

Jason Koma, a spokesman for the Ohio State Medical Association, said the nation's economic
troubles hit doctors as well. "It's hard to keep the doors open if you have a high number of
Medicaid patients," Koma said.

Cutler, a 60-year-old native of Brooklyn, N.Y., has practiced in the neighborhood since 1982. He
said eight of his patients became homicide victims over the past few years.

He ran for the Columbus school board in the 1980s, fighting to save the old Central High School,
which was eventually closed and was incorporated into COSI Columbus, a science museum on the Scioto
riverfront.

He lives within walking distance of his office, which is filled with piles of papers and files.
His laptop rests on an examination table, next to where a black cat lounges.

A Yorkshire terrier puppy sits in a playpen at the back of the room. A 19-year-old calico cat
roams the office.

Ben Shirey didn't seem to mind the animals during a visit last week. Shirey, 22, traveled about
80 miles from Centerville to see Cutler.

His mother, Debra Shirey of Circleville, said Cutler diagnosed her son's leukemia in 1989.
Cutler said the 22-year-old is now perfectly healthy.